Healthcare in the UK

Is there anyone who has stayed a long time in Spain and then gone back to the UK and become ill?  I have heard that there is a law saying that after 6 months away, you are not entitled to free treatment on the NHS.  That doesn'y quite square with the EU and all that does it and we have a Spanish freind who received lots of NHS care in the UK.  I have tried to find out here as it may limit the amount of time each year we spend in Spain, but haven't had much luck so far.

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Ask Mrs Blair whether she feels that is an infringement of your human rights under EU Law. If its good enough for her to say that she is entitled to the freebies she ligs out of of her position as the wife of the Prime Minister then surely if you return to the UK having paid your NI contributions for your working life to take up residency in the UK again surely, surely that cannot be true. I suppose if you were a refugee from Uzbekhistan that had never paid NI in your life and had just turned up in the back of a lorry then it would be ok - actually they would probably give you a suite at the Ritz for convalescence as well. Sorry I am beating my drum but I just cannot believe that to be so. The department of health must be able to answer you that question - if not then it needs to be asked in the House of Commons!! 

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This message was last edited by JeansSis on 5/16/2007.

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1) If you have never told your UK GP that you've gone away, how would they know? Do you have to re-register every year or something? Or get ill regularly to prove you are still there?

2) Having said that, if you are "a resident of Spain (been there 4 yrs)"  how can you "go home" to "your doctor" in the UK?

3) But, if you are leaving Spain permanently to take up residence in the UK again, surely you would then be entitled to NHS, like any other Uzbek? Please, someone confirm this!!!

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We are still on the UK quacks books and Rose goes back regularly for check ups - she is on Thyroxin and prefers to have it monitored on trips back. I understand that becuase most GPs are overstretched in the UK they send your records back after about three years if they havent seen you - this would be the same if still living in the UK. Had problems with clients when I was still back there trying to get a GP's report for a life cover application for a client who had not been to his doctor for over twenty years - just had no reason - I guess there are those who never get sick

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So are you saying that because the guy had never been sick, it was difficult to prove he was healthy? Is the whole world going mad????

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In short yes - not quite as straightforward Insurance Co insisted on GP report as standard for the level of cover required - needed Gp details but they had "derigistered" him as lack of need. Hence it caused a slight problem and he was sent for a medical on the grounds that he had never been sick - slight tone of irony in the voice.

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If you are resident in Spain, your health cost money will have been transferred across to the Spanish Health system.  As I have mentioned before, it is not where you have paid your money in but where you are resident that counts.  Therefore, going back to UK you would be counted as a visitor and would be entitled to free emergency treatment, such as a broken leg or an asthma attack etc. but would be liable to pay for treatment for ongoing problems, for example diabetes.  You cannot register with the NHS for General Medical Services unti you have been resident for 6 months.  Once you intend to leave UK for over 3 months, you should de-register with your GP and obtain the necessary documents from Newcastle to take with you, an E121 if you are disabled or retired, or an E106 if you are taking up work in Spain.  This documentation will transfer your contributions to your new country of residence and you will be entitled to free treatment there.

The NHS is always under attack for giving free treatment to people who are not entitled to it, mainly people from Asia and Africa who come in and claim for maternity etc.

The GP who took you off his books because he hadn't seen you for some time is totally wrong in doing so.  If you are not seen for some time, the procedure is to write to you to confirm you are still resident at that address.  This, however, is more than likely the fault of your Health Authority and not the GP.  Your GP gets paid £54 per year to look after you.  The Health Authority is always trying to cut down costs by removing so-called "ghost" patients. 

Any person from abroad coming into my surgery is asked to produce a passport with a student visa, a work visa for over 5 years or an asylum seekers number before being given free treatment.  No stamp, no treatment except for emergency.

In theory, these rules apply to expats.  In reality, we never charge British born citizens, of whatever colour, race or creed,  for treatment.  You may, however, be sent a bill by Newcastle for any medication you have received but I have never come across a case of this happening.

Also in the GPs defence, some of the questions asked on insurance reports can only be answered if the GP has seen the patient.  How, for example, can a GP fill in "latest Blood Pressure" "current cholesterol levels" "current smoking status" etc if they haven't seen the patient for 20 years?  Even the BP readings must include those in the last five years so they will be called for an examination if they haven't seen their GP.  90% of patients have seen their doctors in the last 2 years so wouldn't be called for an exam. 

Please don't complain about the NHS running out of money for treatment if you are fiddling the system yourself.

PS If you are going back to UK the same rules, of course, apply.  The Spanish Health Authority will transfer your payments back to the UK and you will, once again, be a part of the UK NHS system as a resident there.
PPS It may all be the EU but, when my wife had a skiing accident in Italy, the first thing the doctors' receptionist did was to pull out the old Barclaycard machine before she would even tell the doctors we required treatment.  E111? You have to go to a hospital which is three hours away down the mountain. 

This message was last edited by bobaol on 1/25/2007.

This message was last edited by bobaol on 1/25/2007.

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Bobaol,
That is very  interesting. My husband, 8 year old son and I moved to Catalonya summer 06. We are not retired and not working. (see thread Free health care in Catalonya) We now have our Health cards which give us health care here and in the rest of Spain.
Question. Do you know if we can get a European Health Insurance Card (old E111) to cover us when we return for visits to the UK?
Having asked that, do we really need one? Any country will help in an emergency and it's only emergency care that I worry about. We had our E106 but were not asked for it. (We have an income from property rented out in the UK so will be paying tax on that, how that helps with Ni contributions I don't know, but it seemed relevent!)
Regards,
Fiona

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You are advised to get a EHIC in Spain to cover you when visiting other European countries.  It is called a tarjeta de sanitarios europa.   Depending on where you are, you should be able to apply for one from your local ayuntamiento, each province varies on where to get one.

You will definitely be asked for it in France or Germany if you need emergency treatment.  You will not be asked for it in UK as the policy there is to treat anyone on an emergency basis and you need to register at  your GP surgery as an Immediate and Necessary patient.   You cannot register in the UK as a temporary resident unless you have two UK addresses, eg seeing a doctor in Eastbourne when your GP is in Halifax.  If your main address is abroad, you will be seen as Immediate & Necessary and it is part of the GPs terms of service to treat you in an emergency.  Any EU, EEA, Swiss, Norwegian or some Commonwealth citizens are entitled to register immediately in UK as a regular patient if they move back there, the six month waiting is only for people outside these countries.  I think only Canada, Australia and Barbados are the commonwealth countries allowed but please don't quote me on that. 

Because of the very confusing rules issued by Health Authorities and the fact that we have a tradition of free at point of service healthcare, most GP surgeries are not geared up to charging for treatment as most other countries are so you may find the rules differ depending on interpretation by the surgery.  The NHS is clamping down on Health tourists and secondary care providers (ie hospitals and A&E departments) are getting their act together and charging those who come to UK for maternity or ongoing health problems.  Primary Care providers (ie GP surgeries) are not yet in the groove but it is changing.  We find patients asked to pay for treatment (mainly maternity or, would you believe, asking for free travel vaccines when they have come into the country from Africa) will go away and try another surgery until they find one who will treat them for free (the word "free" is a misnomer as it should really be "publicly paid for" ie the taxpayers).

It does annoy me that the UK is looked upon as a "Free" provider of health care to the world.  The reason British people with serious diseases such as cancer cannot get their medication or have to wait ages for treatment is due, in a very large part, to non-entitled persons getting there before them.  There is only so much money to go around and the Hounslow Health authorities (the one near Heathrow) estimated a staggering £2 billion was spent on treating health tourists.  Imagine how much Herceptin that would buy!!! We have also estimated that 12% of the patients in my surgery alone (no names, no pack drill) are fiddling the system by registering at relatives addresses and using the NHS for "free" treatment.  We have 10,000 patients so imagine how that could cut down the time you wait for a GP appointment if we got rid of them all.  And, just as a point of interest, if all the money spent on the national lottery each week was put into the NHS, it would keep it going for about 3 or 4 hours. 

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This message was last edited by JeansSis on 5/16/2007.

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Dear JeanSis, it would appear that you are advocating a United States of Europe.  Free healthcare for all EU citizens is a wonderful idea but where would the money come from?  You pay taxes to good old Gordon the Grabber (at the moment) not to the Brussels mafia (sorry if this is out of date before I finish typing, you never know).

Even in a more unified country like the USA, your health insurance is only valid in the state you live in.  If you, for example, live in Chicago and go on holiday to Orlando, you have to take out travel insurance.  The reason health care for poor baby Emma (I pray everything will go allright for the poor little mite) is so much better in the US is that the US government spends half as much again on healthcare than we do.  They get this from taxation on health insurance which is ploughed back into the system, unlike our National Insurance which also pays for welfare and pensions as well as health.  We talk about the US only providing health care for those who pay but that is not true.  Their county hospitals (like the one in ER) provide free treatment for those who can't pay but takes money off those who can afford it.  Medicare pays for their retired population and the VA (Veterans Association) looks after anyone who served in any of the Armed Forces including the Coastguard.  Americans may only get two weeks paid holiday a year but health insurance is generally paid for by their employers as part of the job. 

The money you have paid in UK will be transferred to Spain when you eventually move there so you will be contributing to the Spanish system.  This money, however, will no longer be in the UK system so should you receive free treatment there as well?  And, sorry, but your taxes don't count.  These have gone to pay for the police, armed forces, schools, outreach worker, gay and lesbian rights counsellors etc. etc. And don't forget our marvellous politicians with their guaranteed blue-chip pensions and escalating pay (bet you wish you could vote on your pay rise every year, don't you?). 

And, yes before you ask.  I am advocating that those in UK who can afford it should pay into a health insurance scheme.  Only those who have paid into it should be entitled to use it.  Those born in the country on the poverty line, which is getting bigger every year, should have the right to be looked after by the state but those from elsewhere, unless absolutely bona-fide refugees, should have to pay the full whack for the lot.  We should also take a leaf out of America's book and cap the amount of profit the drug companies can charge the Health Service (did you know a tetanus vaccine costs 25p to produce and the companies charge the NHS £15 for it? )  Once a drug company has recouped its developement costs, drugs should be capped at no more than 10% above production and distribution costs.  Anyway, another high horse of mine just went for a drink of water and the 2 euros in my machine at the pub internet station is just about to run out.

PS my point about the lottery is that it would be a mere drop in the ocean.  The total amount of lottery money wouldn't keep the NHS going for a few hours a week let alone pay the NHS.  My point was to try and explain how much the NHS actually costs the country.

This message was last edited by bobaol on 1/25/2007.

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This message was last edited by JeansSis on 1/25/2007.

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Hi Bob if I have been misinterpreted then I apologise. No intention on my part to slag off GP's but more to berate a system that can automatically de register a patient for not being ill. I daresay that at some point his surgery had contacted him to establish if he was still living or at the address (which he was - same place for 25 years) and he had misplaced it or not bothered to reply. I certainly understand that no Dr would compile a report without a medical so no criticism there. I think you guys do a sterling job in the face of a lot of adversity - my pop isnt at the NHS but the managment tiers above the NHS and their bosses. Strangely enough the same people who have no problem voting themselves inflation busting pay rises and final salary pensions that nobody else can afford in the caring sharing world of the two B's. No pointed finger at either side - I am a fully paid up member of the cynical party.

I know that in the UK you pay your taxes to Mr Brown but if if it is not your taxes (and mine previously) that pay for what is going on in Brussels just who is that pays Mr and Mrs Kinnock and the Boys from Brussels (perhaps they could make it into a movie with lots of Kinnock clones - ugh what a thought).

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Smiley says: "I am a fully paid up member of the cynical party."

Where do I sign up?

And can someone please correct the spelling of HEALTHCARE in the title of this thread?

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And all along I've been talking about Healt Care.  Darn it, a healt is, of course, a small furry animal that lives in the Scottish lowlands and is often preyed upon by haggis coming down from the hills.  Now you know how to look after them, perhaps we can talk about healthcare.

 

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This message was last edited by JeansSis on 5/16/2007.

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Well you learn some thing new every day.
There was me thinking it was from the Latin 'dondearriba' !

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Roberto you wouldnt want to join  owing to the clothes you have to wear on saturday nights - the reason its spelt that way is because Justin was having an Irish day and we dont use the h in the middle.

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Isn't dondearriba a word pinched from the Geordies, as in "where up, lad". 

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